Burns:

The skin is the body's first line of defense against external factors we encounter during our day, making it susceptible to significant injury. Burns are a common type of injury that affect the skin. Burns result from damage and destruction of body tissues due to exposure to heat, electricity, sunlight, and chemicals.
Burns can have several types and their effects range from swelling, scarring, blistering on the skin, and in severe cases, burns can cause significant fluid loss leading to shock and potentially death.

There are several types of skin burns based on the severity of the injury:

- First-degree burns: Damage is only in the outer layer of the skin (epidermis) and is also known as superficial burns. Examples include sunburns. The skin may be red and painful (due to intact pain fibers), and there may be swelling but usually no blisters.
- Second-degree burns: Damage is in the outer layer of the skin and the layer beneath it (dermis) and is also known as partial-thickness burns. They are extremely painful with redness, blisters, and fluid-filled bubbles due to fluid leakage. They often do not require skin grafting because the skin appendages containing stem cells (multi-potential cells capable of renewing the skin) remain intact. However, if the skin burn is extensive, other measures may be needed.
- Third-degree burns: Cause damage to the entire skin and are also known as full-thickness burns. There is no pain due to the destruction of nerve endings (you may feel pain from first and second-degree burns near third-degree burns). The skin appears dry and dark red, brown, or black. In this degree, complete loss of skin occurs, and therefore, self-healing is not possible. Patients often require surgical skin grafting.
- Burns can reach deeper levels beyond the skin to tissues underneath such as bones and muscles, known as fourth-degree burns.

Causes of burns:

Heat: such as fire, steam, hot liquids, and surfaces are the most common causes of burns.
Chemicals: like acids, alkalis, and some harsh cleaning products.
Electricity: high voltages and some faulty electrical devices, including lightning.
Radiation: including sunburn and burns resulting from certain therapeutic procedures like cancer treatment or laser therapy.
Friction: harsh scraping of the skin can lead to tearing and burning due to energy generated by friction, such as rope or carpet burns.

What to do when you get burned:

1- First, move away from the source of the burn and remove any burning clothing (except tightly embedded clothing).
2- Apply lukewarm water (not cold) to help alleviate pain.
3- Do not use ice, butter, or any types of greases.
4- Remove jewelry and tight clothing from the burned areas, apply a clean and sterile bandage, and you can apply an antibiotic cream or burn-specific cream (when the burn is first or second degree).

When to seek medical help:

- When the burn is severe or if it is in areas such as the head, close to the eyes, hands, mouth, genital areas, and when the burn covers wide areas even if it is moderate, seek medical help.
- If the burn is caused by chemicals or electricity, or if it occurs in a child under 5 years old or an adult over 70 years old.
- If you experience the following symptoms, see a doctor immediately:
1- Fever develops.
2- Large amounts of pus leakage.
3- Significant skin swelling.
4- Blisters filled with brown or greenish fluid.
5- If the burn does not heal within 10 days to two weeks.
It is important not to touch the blisters or try to open them without medical assistance.

How burns are assessed:

- The degree of burn (thickness of the burn): Indicates how deep the burn goes into the skin.
- The extent of the burn: The area of the burned region.

Complications of burns:

1- Dehydration: Important complication resulting from fluid loss from tissues, in serious burns involving large areas of skin, emergency measures are taken to determine the amount of intravenous fluids that need to be replaced.
2- Inhalation respiratory problems: Resulting from smoke fumes from fires.
3- Low blood pressure and entering into shock due to significant fluid loss.
4- Infections and sepsis: Resulting from loss of skin allowing bacteria and foreign bodies to enter the body.

Burn Treatment:

It is important to know the available treatment options for burns. Consult a doctor to determine what is suitable for you based on your condition:
- For minor burns (first or second degree), which usually do not require hospitalization or medical care, they can be treated at home with burn creams and pain relievers. They can cause severe pain in some cases, hindering you from performing your daily activities.
- Moderate burns may require hospitalization and include first or second-degree burns that cover large areas of the body. They often improve quickly with treatment and may require fluid replacement.

Severe burns require care at a burn center for:

- Second-degree burns covering more than 10% of the body.
- Third-degree burns.
- Burns on the face, eyes, mouth, genital areas, and hands.
- Burns accompanied by other injuries such as bone fractures or respiratory problems.
Fluid replacement is done through intravenous injections, and the patient may be placed on a ventilator if necessary. The patient remains under close monitoring to control blood pressure and maintain vital signs.
In general, burn treatments aim to remove damaged skin and tissues, protect remaining tissues from infections, and prevent scarring. Physical therapy is included in burn treatment programs to preserve lost tissue function and prevent tissue atrophy, especially when the injury involves joints and muscles responsible for movement.
There are many cosmetic procedures aimed at minimizing the impact of the injury, such as ultrasound therapy, skin grafting to cover large wounds, and tetanus injections. Inform your doctor if you are interested in any cosmetic procedures.
If you have questions about burn evaluation or treatment, consult a dermatologist or family doctor promptly.

Here are some tips for preventing burns:

1- Do not leave gas stoves, ovens, or heaters unattended while in use.
2- Do not smoke in bed or in flammable areas.
3- Do not leave children alone in a room with a heater or allow them to use kitchen tools unsupervised.
4- Pay attention to electricity; ensure your electrical appliances and wiring are in good condition.
5- Educate your children about the dangers of fireworks, matches, and keep them away from them.
6- Install fire and smoke alarms in your home.
7- Have fire extinguishers on each floor and in your kitchen.
8- Establish an escape plan in case the main entrance is blocked.
9- Avoid touching chemicals without protection; do not touch corroded batteries or inhale chemical gases or vapors.
10- Keep emergency numbers for ambulance and fire services in your area.
Psychological and social support for burn victims is crucial, as depression and anxiety often persist along with questions about their future and how to interact with people after receiving treatment. It is important to provide psychological support to the patient and offer everything they need to overcome this period because prolonged psychological stress can affect the patient's physical health, especially their immune system, making them more vulnerable to infections. It is necessary to seek psychological consultation if psychological problems persist for a long time after the incident.